Written by Nina Gonzaelz, MD, MPH, co-founder of Hello Brave
When my son was just under two years old, he came down with a common cold that triggered reactive airway disease resulting in respiratory distress and a trip to the emergency department. While crying and gasping for breath, he was quickly triaged to an exam room and started on a breathing treatment. Doctors and nurses came in and out of the room, checking vitals, listening to his lungs, and adjusting his oxygen. He was taken for an x-ray and continued to be monitored closely. My son clearly had no idea what was going on and was alarmed by all the new people and machines. I was at his side the whole time, but it was hard to watch him struggle, pulling at the mask on his face and crying when new people came in the room. After several hours, we were discharged home. When it was time to go back to the hospital for a routine follow up, my son, who was usually eager to see the small aquarium in the pediatric waiting area and say hi to his doctor, was terrified. He clung to me tightly, and his little body wouldn’t stop trembling. His emergency department experience had clearly left a lasting impression of fear and anxiety that was triggered by returning to a medical setting.
June, recognized as Post-traumatic Stress Disorder (PTSD) Awareness Month, highlights the importance of understanding and addressing trauma. PTSD is an anxiety disorder that some people develop after seeing or living through an event that caused or threatened serious harm or death. Most people think of PTSD in the context of witnessing or experiencing terrifying events such as in wars, abuse, or other forms of violence. But there is another type of PTSD that stems from the very place you go to improve health -- medical settings.
Medical procedures and hospitalizations, while necessary, can be traumatic for children. Pediatric medical traumatic stress (PMTS) is a set of psychological and physiological responses of children to events such as pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences. Thankfully, there's a growing movement called "trauma-informed care" that aims to make medical experiences less stressful for our kids.
What is Trauma-Informed Care?
Trauma-informed care recognizes that medical procedures can trigger stress and anxiety in children, potentially leading to PMTS. This approach focuses on minimizing the emotional impact of medical treatment and promoting healing.
How Does Trauma-Informed Care Help?
Trauma-informed healthcare providers use specific techniques to reduce stress in children, including:
Providing Choices: Allowing children to make small choices (like which arm to use for a shot or what flavor medicine to take) can help them feel more in control.
Distraction: Engaging children in games, stories, or other distractions during procedures can take their minds off the discomfort and fear.
Parental Presence: Encouraging parents to stay with their child during procedures provides comfort and a sense of security.
Creating a Trauma-Informed Environment
Healthcare professionals can go beyond these techniques to create a more trauma-informed environment:
Staff Training: Educating staff about trauma and its impact on children can help them respond with sensitivity and support.
Comfortable Spaces: Designing child-friendly spaces with soothing colors and activities can help reduce anxiety.
Communication: Explaining procedures in simple terms and answering questions honestly can help children feel more informed and less scared.
What Can You Do as a Parent?
Ask About Trauma-Informed Care: When choosing a healthcare provider, ask if they use trauma-informed practices.
Be an Advocate: If your child is anxious or scared, don't hesitate to speak up and ask for support.
Prepare Your Child: Talk to your child about what to expect during a procedure, using age-appropriate language. Picture books are a great resource to prepare your child for what to expect.
Taking Care of the Whole Child
Just as we prioritize our children's physical health, we must also prioritize their emotional well-being. Trauma-informed care recognizes that medical experiences can impact a child's emotional health and takes steps to minimize that impact. By advocating for and utilizing trauma-informed care, we can ensure that our children receive the best possible care, in body and mind.
At Hello Brave, our mission is to improve medical experiences for kids, and we have aligned ourselves with the principles of trauma-informed care. We understand that one of the best ways to reduce fear and anxiety associated with medical diagnoses and procedures is to help kids and their families understand what to expect for a given medical experience.
Our books offer parents a tool to help prepare their kids for medical encounters by describing what to expect, explaining the why, and proactively addressing common misconceptions. And we’re excited to announce that we will soon be publishing a Brave Kid’s Book of Distractions, full of jokes, riddles, games, mindfulness techniques, and more to help kids take their minds off the discomfort and fear of medical procedures.
Together, we hope to reduce medical traumatic stress and bring joy to everyday medical experiences.
Resources
Kassam-Adams, Nancy, and Lucas Butler. "What do clinicians caring for children need to know about pediatric medical traumatic stress and the ethics of trauma-informed approaches?." AMA journal of ethics 19.8 (2017): 793-801.
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